在预测妊娠并发症方面，与自然受孕相比，体外受精/卵胞浆内单精子注射（IVF/ICSI）患者孕早期非整倍体生化标志物并无额外益处。

The first trimester aneuploidy biochemical markers in IVF/ICSI patients have no additional benefit compared to spontaneous conceptions in the prediction of pregnancy complications.

作者信息

Szymusik Iwona, Kosinski Przemyslaw, Kosinska-Kaczynska Katarzyna, Warzecha Damian, Karwacka Anetta, Kaczynski Bartosz, Wielgos Miroslaw

机构信息

First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.

First Department Of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza Square 1/3;02-015 Warsaw, Poland, Tel.: +48 22 5830300, Fax: +48 22 5830302.

出版信息

J Perinat Med. 2018 Nov 27;46(9):953-959. doi: 10.1515/jpm-2017-0199.

DOI:10.1515/jpm-2017-0199

PMID:29216009

Abstract

OBJECTIVES

The aim of this study was to determine if the levels of biochemical aneuploidy markers in in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) pregnancies differ from those in spontaneous pregnancies and to verify if biochemical markers could predict pregnancy outcome in IVF/ICSI gestations.

METHODS

This was a prospective observational study performed in a group of 551 patients who underwent a combined first trimester prenatal screening (ultrasound scan and serum markers). All patients were divided into two groups according to the mode of conception: IVF/ICSI pregnancies (study group) and spontaneous conceptions (control group). The concentrations of first trimester biochemical markers were presented as multiples of median (MoM) and were compared between the study and control groups. Analysed pregnancy complications included: preterm delivery (PTD), small for gestational age (SGA), gestational hypertension (GH), preeclampsia (PE) and gestational diabetes (GDM).

RESULTS

The analysis was performed on 183 IVF/ICSI and 368 spontaneously conceived gestations, with complete data regarding obstetric outcome. There were no significant differences in the concentrations of biochemical markers between the analysed groups. Pregnancy-associated plasma protein-A (PAPP-A) levels were lower in hypertensive than in normotensive patients, although the difference was not significant. Twenty-three patients had GDM (12.5%), 16 had GH or PE (8.7%), SGA was diagnosed in 18 (9.8%) and 25 delivered preterm (13.6%).

CONCLUSIONS

The trend for lower PAPP-A MoM was visible in all affected patients, although the results did not reach statistical significance. The first trimester biochemical markers in assisted reproduction technique (ART) pregnancies do not seem to have additional effect on predicting the risk of pregnancy complications.

摘要

目的

本研究旨在确定体外受精（IVF）/卵胞浆内单精子注射（ICSI）妊娠中生化非整倍体标志物水平是否与自然妊娠不同，并验证生化标志物能否预测IVF/ICSI妊娠的结局。

方法

这是一项前瞻性观察性研究，对551例行孕早期联合产前筛查（超声扫描和血清标志物）的患者进行。所有患者根据受孕方式分为两组：IVF/ICSI妊娠（研究组）和自然受孕（对照组）。孕早期生化标志物浓度以中位数倍数（MoM）表示，并在研究组和对照组之间进行比较。分析的妊娠并发症包括：早产（PTD）、小于胎龄儿（SGA）、妊娠期高血压（GH）、子痫前期（PE）和妊娠期糖尿病（GDM）。

结果

对183例IVF/ICSI妊娠和368例自然受孕妊娠进行了分析，有完整的产科结局数据。分析组之间生化标志物浓度无显著差异。高血压患者的妊娠相关血浆蛋白A（PAPP-A）水平低于血压正常患者，尽管差异不显著。23例患者患有GDM（12.5%），16例患有GH或PE（8.7%），18例诊断为SGA（9.8%），25例早产（13.6%）。